Objective To study the method and safety of coagulation factor replacement in patients having fracture with hemophilia. Methods Five male hemophilia patients with fractures were treated, and the mean follow-up period was 9 months. Under the cooperation with the hematology department. Monitored levels of factors Ⅷ and Ⅸ perioperatively, and established routine process of factor replacement, according to the China guideline of Hemophilia dialogue and tre atme nt. Results Hemophilic patients who had undergone therapy of perioperative coagulation factor replacement could suffer treatment of fractures. All patients had no complications such as hematoma, infection. But one patient firstly accepted operation, after 4months, the plate was broken, proformed conservative treatment. Conclusion Coagulation factor replacement and monitoring of coagulation factor levels are the key to the success of treament in hemophilic fracture patients.